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“Everything should be made as simple as possible, but not simpler.” – Albert Einstein

Physician Burnout – Praying for a one-step solution is human nature and a trap!

One of the key features of physician burnout is a desire to run away, escape, make the pain stop. When you are deep in the downward spiral, your mind drops to its knees and prays for a simple, one-step solution to the agony and despair.

We ask basic questions like:

1. What is the solution to physician burnout?

2. What can I do to solve this, make it go away and get on with my career and my life?

Because our questions are simple, we assume a simple answer — a solution, a magic pill, a one-shot fix — will come to our rescue.

This is magical thinking and a search that is doomed to fail !

In this blog post, let me show you the simplest way possible to prevent physician burnout in any healthcare organization that employs physicians.

I promise to make it as simple as possible for you, but no simpler.

THREE KEY DISTINCTIONS

Distinction #1: Problem vs. Dilemma

First, you must understand that physician burnout is not a problem. Problems are simple challenges that have a one-step solution, like third grade math.

2 + 2 = 4

8 + 8 = 16

Simple, right?

Physician burnout is not nearly that simple. Nope, burnout is a classic dilemma – a never ending balancing act. This blog post will explain the importance of this distinction and show you a number of additional situations where doctors mistake dilemmas for problems.

HINT: the “problem list” in a patient’s chart isn’t even a list of problems.

Distinction #2: Strategy vs. Solution

Now that we are calling burnout by its right name – DILEMMA – you will quickly realize there is no one-step solution. You can’t solve a dilemma for a simple reason – it is not a problem. You address a dilemma with a different word that starts with the letter “S”.

STRATEGY

Rather than a single step, a strategy contains 3 – 5 steps/parts/tools that you use in combination to maintain the energy balance that you seek.

If you believe there is a one-step solution that makes burnout all go away, please let that go now. It is a fantasy everyone in healthcare must release, once and for all – the sooner the better.

Distinction #3: Canary vs. Coal Mine

It would be great if you could take full responsibility for your entire burnout prevention strategy. If you could personally render yourself impervious to burnout … like Superman or Wonder Woman. That ain’t happenin’ for a simple reason:  Resilience is never enough to prevent physician burnout. Here’s why …

Burnout in healthcare happens in a classic setting of a Canary in a Coal Mine.

Back in the early 1900’s coal miners died of two major causes – cave ins and bad air. If you are digging into a coal seam, it will contain pockets of CO and CO2 that can rush out and kill you. In this age before carbon monoxide detectors, the miners needed an early warning system. They turned to canaries.

Canaries have two characteristics that a coal miner loves. They never stop singing and they die in bad air before a human. Each shift would take a canary into the mine in a small cage. They set the bird off to the side and got busy digging coal. At regular intervals in their shift, the crew would pause and listen for the bird.

· If the bird was singing they went back to work

· If the bird was silent they checked the cage

· If the bird was down, they dropped tools and ran out of the mine

Physicians – and all other healthcare workers – are the canaries in the coal mine of healthcare

We are indicators of the conditions in the mine. Our current physician burnout epidemic is a reflection of the stresses of the modern practice of medicine.

· The work is hard, complex and changing all the time

· The tools are imperfect and all of us are human

· The systems often get in our way, with EMR a prime example

Sure, you can make us as resilient as possible – but what about detoxing the mine a little bit here?

Now we are set to answer our original inquiry. What is the simplest effective approach to the prevention of physician burnout?

The best answer is …

A Pair of Strategies (2) Operating Simultaneously and In Parallel

1) A prevention strategy for each individual physician – The Canary.

This strategy is the essence of physician resilience. However, the individual doctor will never be resilient enough to compensate for a toxic work environment and hostile group culture.

2) A system-wide prevention strategy for the organization/group – The Coal Mine

This is the essence of the Quadruple Aim. However, the organization cannot be supportive and efficient enough to eliminate burnout completely. We are programmed to burn out from the start.

Only now can the physicians and the organization work together to minimize burnout for everyone in the system: Doctors, staff and leadership alike.

This is the minimal level of complexity required to prevent physician burnout.

These principles are true whether you are one of 1000 employed providers in your group or a solo doc with a DPC practice. In our work with thousands of over-stressed and burned out doctors, we have identified over 235 tools to prevent physician burnout. These are the options you can choose from when building a strategy to match your unique pattern of stressors.

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What does this mean for you and your organization?

Here is a checklist of questions you can ask right now:

1. Does your organization understand the fundamental nature of burnout and the need for twin, parallel strategies?

2. Does your organization teach and support all providers building a personal burnout prevention strategy?

3. Does your organization have a formal burnout prevention or wellness committee in the leadership structure?

4. Is that committee having a positive impact on the efficiency of the systems and the level of support providers feel from the group culture?

If you don’t like your answers to those questions or don’t understand why these answers are critical to your ability to prevent physician burnout, we have 10,000 hours of experience to share. Let us help you build and deploy a proven burnout prevention system that will work for you and your colleagues.

PLEASE LEAVE A COMMENT:

How is your personal prevention strategy going? What is working for you? What does your organization do to support your health and wellbeing? How is that going?

Dike Drummond MD, CEO

Dr. Dike Drummond is the CEO and Founder of TheHappyMD.com. A Mayo trained Family Practice Physician, Dr. Drummond is a leading coach, trainer and consultant on the prevention of burnout in individual physicians, and the realization of the Quadruple Aim in healthcare organizations.

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